Transcranial magnetic stimulation (TMS) delivers painless magnetic pulses through a coil placed on your scalp to stimulate neurons and neurotransmitters, which deliver chemical signals in your brain. It targets areas associated with depression and your moods, promoting and increasing the production of depleted activity and neurotransmitters in those areas.
The goal is to improve communication between all your brain’s regions to help regulate your emotional state. A single course of a non-invasive TMS treatment with little to no side effects can usually achieve this result. It even has a high response rate in patients who have treatment-resistant depression. While this may sound too good to be true, and some patients worry that the results won’t last, researchers have been investigating TMS to determine whether it has positive long-term results with single treatment courses.
How Are You Feeling?
Brain imaging techniques may track physical changes in your brain, but it is challenging to study how groups of patients feel and measure improvements scientifically. Tools are necessary to help medical professionals understand the severity of the diagnosis as well as the degree of improvement with treatment. Doctors use the tools pre and post-treatment to document patient progress. Here are some of the tools developed to monitor patient gains:
- The Nine Item Patient Health Questionnaire (PHQ-9): Patients use this questionnaire to report the severity of depression symptoms.
- Clinician-Reported Clinical Global Impressions-Severity of Illness Scale: The observing healthcare team uses this form to help document the impact of the patient’s symptoms on their daily life functions.
- Inventory of Depressive Symptoms Self-Report: Patients fill this report out to document the frequency and severity of their depression symptoms.
Can TMS Lead to a Long-Term Remission of Symptoms?
TMS is an effective treatment for individuals with depression resistant to medication, making it a great option for individuals with persistent depressive symptoms after traditional medication therapy.
NeuroStim’s expert staff have performed more than 65,000 treatments since 2018 at their TMS treatment centers in the Puget Sound area. During that time, the majority of their patients have seen a remission of their depressive symptoms with 70% experiencing greater than 50% improvement and 46% achieving full remission.
While these results are promising, you may wonder if they will last. Our experience says, “Yes.” The majority of our patients who responded to inquiries a year after completing TMS therapy reported still feeling well a year later.
In 2014, the Journal of Clinical Psychiatry published the results of a study conducted by Dunner et al. that supports this conclusion. Two hundred and fifty-seven patients with major depressive disorder (MDD) were enrolled in the study. Each patient completed a single course of TMS over six weeks. They also completed assessments before beginning treatment and at three-month intervals for one year to track their progress. At the end of the year, 62.5% of patients showed no signs of depression, remaining in remission.
Does TMS Have Significant Side Effects?
While there can be minor scalp discomfort where the magnetic coil is lightly placed, or headaches during the first week of treatment, there are no reported long-term side effects from TMS therapy. These minor symptoms stand in stark contrast to the long list of side effects systemic antidepressant medications can cause: weight gain, difficulty sleeping, and sexual dysfunction.
What Helps Ensure Depression Remission?
While TMS effectively reduces or eliminates depression symptoms, it is not a guarantee. Researchers are still investigating the long-term benefits of TMS therapy, but other therapeutic techniques are encouraged to maximize the positive benefits.
● Talk Therapy
Even if therapy didn’t seem effective before TMS, cognitive behavioral therapy could be beneficial both during and after TMS because it will help you avoid the cognitive loops, leading to a circular decline in your mood.
● Antidepressants
While you may not have responded well to antidepressants in the past, they may help maintain your improved mental state afterward. They can help reduce the risk of your depression returning, supporting your positive response to TMS treatment.
● Lifestyle Modifications
Maintaining normal sleep-wake cycles, regular exercise, and adequate nutrition during and after TMS therapy is crucial. These will all contribute to your well-being. It is important to note these are beneficial in moderation; extreme dieting and exercise regimes will not contribute to TMS treatment’s long-lasting effects.
Additional Factors That Influence TMS Response
1. Medications
If you are taking antidepressants concurrently with your TMS treatment, it can make your medication more effective and increase your overall benefit.
2. Level of Treatment Resistance
While TMS is one of the best options for treatment-resistant depression, TMS response rates are better if your depression isn’t resistant to antidepressants.
3. Personality
If you are more persistent and tend to persevere even when frustrated or tired, you respond to TMS more quickly. A desire to change your life is more important than you may realize.
4. Age
If you are under 60, you are more likely to respond better to TMS.
What If You Don’t Maintain Remission?
Unlike medications with maximum doses, there is no cap to the length or frequency of TMS treatment. Some patients respond better with longer initial courses, some require maintenance sessions, and others need subsequent courses when symptoms reappear. If you find signs of depression returning, see your provider for additional treatment as soon as possible. The more you stay well and keep the depression at bay, the more you strengthen your brain’s wellness pathways to keep you feeling well.
The mental health benefits of TMS treatment can be and are long-lasting for many patients. However, researchers are still investigating many factors that may affect how long benefits last. Talk therapy, medications, lifestyle changes, your age and personality, and your level of treatment resistance all play a part in determining your personal response to treatment. There are many tools to use to overcome depression and TMS can be part of your long-term solution.